Resonant muscle stimulator

ABSTRACT

A method and apparatus use resonant pulses to treat diabetes, carpal tunnel syndrome, arthritis and other maladies by applying a stimulating signal to promote and manipulate blood flow. The stimulating signal may include a resonant sequence that includes at least three pulses, where the pulses of the resonant sequence are spaced relative to one another such that each pulse subsequent to a first pulse in the sequence is effective to progressively stimulate and create tension in a musculature that includes the muscle inwardly from the electrodes and towards the center of the musculature while maintaining the tension created in at least a portion of the musculature by each preceding pulse in the resonant sequence

CROSS-REFERENCE TO RELATED APPLICATION

This application is a continuation-in-part of U.S. patent applicationSer. No. 10/789,861, entitled “Resonant Muscle Stimulator” and filed onFeb. 27, 2004, which is a continuation-in-part of U.S. Pat. No.7,035,691 filed on Jan. 15, 2002, and claims the benefit of the filingdate thereof. The entire disclosure of the above are incorporated intothis application by reference.

FIELD OF THE INVENTION

The present invention relates generally to the field of electronicmuscle stimulation, and more particularly to transcutaneous muscledevelopment.

BACKGROUND

The ability to stimulate or exercise muscle tissue is critical to thedevelopment and rehabilitation of muscle. In nature, alterations in ionchannels cause the brain to generate electronic impulses or synapses. Animpulse propagates along an axon to its termination on its way toinitiating a muscle contraction. As such, characteristics of the impulsecomplement the active processes of the nervous system. Mechanicallygenerated attempts to stimulate muscles often strive to emulate naturalimpulses, working within the confines of axon receptors. Therapists andathletes use machines that produce variations of such signals to developmuscle tissue by inducing a series of contractile twitches thataggregate to form a contraction. Benefits of such stimulation includethe promotion of blood flow and the localized development of muscletissue.

Conventionally, such signals embody a series of discontinuous pulses.Despite charges being measurable in millivolts, each pulse communicatesat least a minimum threshold potential to a muscle. A thresholdpotential corresponds to a voltage level, or charge, as measured at amotor nerve, where the membrane of an axon experiences depolarization.Also called a firing level, it coincides with the moment of a twitch,where the potential in the axon releases its energy into acalcium/adenosine triphosphate (ATP) union at one or more togglingbridges in the sarcomere until the axon arrives at zero potential.

In this manner, the threshold potential presented via each pulseinitiates a full-fledged twitching reaction. That is, sarcomere tissueof a muscle creates one twitch worth of contractile force in response toan application of a generated threshold potential. Successive bridgingof adjacent sarcomere tissue comprises a contraction. Of note, atoggling reaction will not occur if the stimulus is sub-threshold inmagnitude, i.e., it fails to convey the requisite threshold potential.The contractile reaction at each bridge in the sarcomere is thereforeall-or-none. In this manner, conventional techniques repeat pulses ofidentical potential and duration to produce consecutive twitches thatadd up to a contraction. In this manner, each pulse of a signal willtheoretically stimulate a next twitch.

In nature, sarcomere bridges toggle simultaneously across the length ofeach muscle as individual twitches aggregate to form a singlecontraction. In this manner, the twitches are said to toggle uniformlyacross a muscle. Such uniformity evades electrical attempts to stimulatemuscle. In contrast, conventional applications use single short pulsesthat may succeed in toggling a high concentration of sarcomere bridgesnear the electrodes, but ultimately fail to stimulate more distantbridges. That is, while a high frequency application may initiallytoggle more bridges, the shorter spacing of the pulses is too small toallow time for depolarization and nutritional replenishment, ultimatelyfrustrating continuing contraction.

As such, any contractile reaction initiated by the pulse is ended withina fraction of a second. Conversely, if the pulse rate is made slowenough to allow for depolarization and nutritional replenishment,accommodation drops in proportion to the drop in frequency, thus thedeeper penetration is made possible. However, penetration comes at theexpense of pain from the yanking and dropping effect produced by thetoggling, de-toggling, re-toggling of more and more bridges in moresarcomeres with the increase in time between pulses as the frequencydrops.

Other prior art techniques attempt to affect larger portions of themuscle by extending pulse length. However, such attempts still fail toachieve a uniform contraction. Namely, sarcomere bridges of the portionof the muscle nearest to the electrodes will release due to polarizationand nutritional problems prior to an adjacent portion of the muscletoggling. The duration of the pulse causes the bridges in sarcomerescloser to the center of the muscle to toggle, but only at the cost ofpainfully yanking the spent and relaxing sarcomeres nearest theelectrodes into a stretched condition as the process travels in a waveor ripple effect outward from the electrodes, but inward toward eachother.

By the time the bridges in the middle sarcomeres begin to toggle, themass of the muscle has developed a crushing velocity to add to thetwitch. Those sarcomeres of the muscle nearest the electrodes havealready been spent. Despite the relatively weaker twitch of the centersarcomeres, the hyper-compression, as the sum of the above, nonetheless,tugs on adjacent sarcomeres. Over time, repeated applications willincreasingly stress and deplete energy supplies of muscle tissues.Repeated applications further produce relatively little beneficialeffect, because the muscles are being stretched out of shape,traumatized almost as much as they are being treated. Additionally, highcurrents associated with long pulses stings the skin of the user. Thus,stimulation of sarcomeres distally positioned from the electrodes hasnot been possible without incurring preclusive pain and potentialdamage.

Known techniques used to address such factors include incorporatingperiods of recovery in between pulses. Sufficient lengths of suchperiods may allow the muscle to partially prepare for anothercontractile twitch. Muscle may use this short period between pulses toreplenish a portion of expended ATP and calcium ions before thecontraction process continues, re-initiated by a subsequent pulse. Eachrest time between pulses also allows the body an opportunity topartially reset electrical polarities skewed by its preceding pulse bydissipating capacitance retained in the skin.

Despite these provisions, known pulse applications still sufferdiminished returns with successive pulses due to nutritional depletionand motor-nerve boredom. Unless the pulse rate is so slow that it causesa painful, jerking sensation, there is inadequate time between pulses toallow for complete replenishment and electrical recovery. Consequently,pulses of repeated strength and duration incrementally drain overallmuscle resources. As the muscles strength and supply wane, so does themuscle's ability to contract. As such, a subsequent pulse, identical inpolarity, amplitude, shape and timing produces shallow contractions thatresult in less penetration than the preceding pulse. Less penetrationtranslates into less muscle development, as weaker contractions fail toincrease blood flow to required muscle tissue levels as needed formuscle development.

Still other obstacles hinder the effectiveness of conventional pulsesignal applications. Namely, accommodation may prevent repeated pulsesfrom penetrating deeply into the muscle, mitigating the potentialbenefit of successive pulses. Muscle accommodation regards the abilityof the body to adapt to constant and repeated stimuli. Such stimuliincludes the successive pulses of conventional muscle stimulators. Assuch, a muscle adapts to subsequent pulses in such a manner as it failsto achieve the same level of potential in response to a repeated pulse.Two major factors contributing to accommodation relate to electricalpolarity and nutritional supply as discussed herein.

To compensate for the detrimental effects of accommodation, someapplications attempt to increase the voltage of subsequent pulses tomaintain comparable levels of stimulation. Other applications attempt tocombat accommodation by varying pulse shape, width, height andfrequency. Although such techniques can realize somewhat greatercontractile reactions with less voltage, a targeted muscle stilltwitches in response to each pulse to a lesser degree than to theprevious pulse. Further, while marginally effective in temporarilyachieving deeper penetration, such attempts still result in preclusivepain that frustrates further treatment. In part, this pain stems frominability of known application and pulse variations to affect motornerves (associated with muscle development) to the same degree assensory nerves (associated with pain). In this manner, conventionalpulse designers are limited in the range of voltage they can apply andthe depth of contractile reactions they can achieve.

Significantly, conventional techniques further fail to uniformly addressdifferent types of muscle implicated in a treatment/development session.An inability of prior art pulse applications to simultaneously andconsistently stimulate both slow and fast twitch muscle types oftenresults in disproportionate muscle development. Such undesirabledevelopment detrimentally impacts balance, mobility and other motorconsiderations. The absence of uniformity is, in part, a product of howa single pulse induces different reactions in dissimilar muscle types ofa user. For instance, as a signal propagates through a patient orathlete, fast and slow twitch muscles respond differently toconventional pulses. This limitation is a product of the differentsensitivities and reaction rates of slow and fast twitch muscles.

Fast twitch muscle is developed in response to frequent, quick use. Fasttwitch muscle is common in muscle groups that control fine motorfunctions, such as the wrist and hand. Consequently, fast twitch musclesprocess electrical stimuli relatively quickly. Of note, such muscles areprone to tire quickly and are vulnerable to overstimulation, causingtetany, a painful tightening of muscles. In contrast, slow twitchmuscles react more slowly to stimuli than do fast twitch muscles, andthey tire less easily. Slow twitch muscles are developed where smooth,methodical muscle contractions are common. For instance, regular motionsand support realized by muscles of the back will typically developassociated muscles as slow twitch.

The disparate reactive characteristics of slow and fast twitch musclespreclude known transcutaneous signals from uniformly addressing bothmuscle types. Namely, no conventional pulse train can simultaneouslysustain even distribution of contractile twitching reactions throughoutboth fast and slow twitch muscles. More particularly, a conventionaltrain of pulses having a frequency synchronized with the response timeof a fast twitch muscle is too quick for a slow twitch muscle to reactto its fullest extent for the voltage applied.

Such an application, to a great degree, fails to stimulate slow twitchmuscles and almost exclusively activates fast twitch muscles because thesignal fails to propagate profound contractile twitches within thesarcomere of the slow twitch muscle. That is, the signal neglects theslow twitch muscle in favor of the fast twitch when both are inline witha signal, resulting in disproportionate development. Of note, highfrequency pulses may still cause overstimulation in the fast twitchmuscle. Such over-stimulation causes fast twitch muscles to painfullytighten, ending a therapeutic session before any gain can be realized inthe slow twitch muscle.

Conversely, slowing the frequency of pulses so as to target slow twitchmuscles can produce dissatisfactory results in fast twitch muscles.Thus, any gains realized in the slow twitch muscle group may be temperedby ineffectual and painful reactions in proximate fast twitch muscles.For instance, slow pulse rates may promote a painful, jerking reactionin fast twitch muscles. As a result, the rate of consecutive pulses maybe too infrequent or painfully preclusive to substantially exercise ortax fast twitch muscles relative to the slow twitch muscle. In thismanner, fast twitch muscles can act as a barrier to treatment of slowtwitch muscles in that the high sensitivity and low pain threshold ofthe fast twitch muscles precludes more extensive propagation of twitchesthroughout slower twitch muscles. As such, exercising slow twitchmuscles remains a challenge to conventional stimulators.

Consequently, what is needed is a single signal capable of uniformlyexercising muscle tissue, while accounting for nutritional, comfort andaccommodation considerations.

SUMMARY

The invention addresses these and other problems associated with theprior art by providing in one aspect an apparatus, method, and programproduct configured to stimulate a musculature. More particularly,embodiments consistent with the invention may apply a resonant sequenceof pulses across the musculature. The resonant sequences may progressinwardly toward the center of the musculature via two electrodespositioned near its ends to uniformly initiate a contraction within themusculature.

Each resonant sequence may include at least three pulses. The pulses arespaced relative to one another such that each pulse subsequent to aprevious pulse in the sequence is effective to progressively stimulateand create tension in the muscle inwardly from the electrodes and towardthe center of the musculature while holding the previously toggledbridges in position. Significantly, tension created in at least aportion of the musculature by each preceding pulse in the resonantsequence is maintained.

Optimized frequencies of the resonant sequences enable the muscle todistinctly register a succession of pulse characteristics within thespan of a single contraction. More particularly, the width, spacing,polarity, amplitude and/or shape of pulses comprising a sequence may bevaried to combat accommodation and minimize discomfort. Such variationmay circumvent the natural tendency of the musculature to adjust to andotherwise accommodate the signal, ultimately translating into deepermuscle penetration and decreased discomfort. Provisions such asshortening the length of successive pulses and the use of faradicwaveform characteristics can further enable deeper penetration withrelatively smaller quantities and durations of applied voltage.

One embodiment that is consistent with the invention may include atherapeutic or developmental instrument that includes hardware and/orsoftware for stimulating a muscle. Such an instrument may comprise, forinstance, a golf club, a baseball bat, a lacrosse stick, a tennisracquet or a hockey stick, among other sports-related instruments. Stillother suitable instruments may include a writing instrument, such as apen. In the case of a golf club, a muscle of a user may be stimulated bythe instrument as the golfer practices her swing. Combining such musclestimulation with the act of practicing the movement of the swing has asynergistic effect of training the muscle as it builds strength.Similarly, a partial paralytic may regain strength in their hand byholding and writing with a pen configured to transcutaneously deliver astimulating signal.

Where desired, the instrument may include at least one electrodeconfigured to deliver a stimulating signal to the holder of theinstrument. For instance, two electrodes may be included within the gripof the club or racquet. That is, electrodes may be positioned on theoutside of the instrument so as to contact the hands of the user. Assuch, different parts of a hand and/or different hands will contactelectrodes configured to deliver the signal. In another or the sameembodiment, wired electrodes may extend from the instrument or anadjacent signal generator to the holder of the instrument. Thisconfiguration may allow other, targeted muscles to be concurrentlystimulated while the user manipulates the instrument. The generator ofanother embodiment is contained within or is otherwise attached to theinstrument. As such, the instrument may include batteries and/or a portfor receiving electrical power.

In any case, the instrument may include a user interface, such asbuttons, dials and/or switches to manipulate the signal. Other userinput devices may include a microphone for use in recognizing voicecommands, as well as a motion sensor. A motion sensor, may, forinstance, activate a signal generation and delivery sequence accordingto the sensed motion of the instrument.

Features of the present invention may have particular application intreating arthritis and diabetes, in addition or in the alternative tostimulating a muscle. Success in these areas may be attributable, inpart, to the manipulation of blood flow enabled by embodiments of theinvention. For instance, an apparatus consistent with the invention mayincrease blood flow according to the signal's travel through amusculature. Other uses of the present invention may extend to the fieldof chiropracty. A method consistent with the invention may provideparticular benefits if used to stimulate a musculature within arelatively short period of time following an injury.

The above and other objects and advantages of the present inventionshall be made apparent from the accompanying drawings and thedescription thereof.

BRIEF DESCRIPTION OF THE DRAWINGS

The accompanying drawings, which are incorporated in and constitute apart of this specification, illustrate embodiments of the invention and,together with a general description of the invention given above, andthe detailed description of the embodiments given below, serve toexplain the principles of the invention.

FIG. 1 illustrates a block diagram of an apparatus suited for generatinga signal in accordance with the principles of the present invention;

FIG. 2 shows exemplary signals that may be generated by the apparatus ofFIG. 1;

FIG. 3 illustrates a first user interface suited for implementationwithin the apparatus of FIG. 1;

FIG. 4 shows a second user interface suited for implementation withinthe apparatus of FIG. 1;

FIG. 5 shows a third user interface suited for implementation within theapparatus of FIG. 1 and configured to attach to clothing of a user;

FIG. 6 illustrates in greater detail the output and polarizing circuitryblock in the apparatus of FIG. 1;

FIG. 7 illustrates a series of steps suited for execution within theapparatus of FIG. 1;

FIG. 8 illustrates four exemplary signals that may be generated andsimultaneously applied within the apparatus of FIG. 1;

FIG. 9 shows exemplary pulse shapes generated by the apparatus of FIG. 1and suited for incorporation into the signal of FIG. 2;

FIG. 10 shows resonant sequences that taper in accordance with theprinciples of the present invention;

FIGS. 11A-C illustrate a muscle contraction sequence in accordance withthe present invention; and

FIGS. 12A-C show a muscle contraction sequence produced by prior artmethods and equipment.

DETAILED DESCRIPTION

An apparatus 10 as shown in FIG. 1 and consistent with the principles ofthe present invention applies resonant sequences of pulses to the skinof a user in order to induce uniform contractile reactions throughouttargeted muscle groups. More specifically, the apparatus 10 of FIG. 1applies the resonant sequence of pulses across a targeted musculature.For purposes of the present invention, a musculature may comprise asingle muscle, as well as some muscle combination or chain. The resonantsequences progress inwardly from the opposite ends of the musculature.The resonant sequences each preferably include at least three pulsesthat are optimally spaced in order to progressively hold and stimulatethe bridges of the sarcomeres of the musculature as they travel towardits center. As such, the resonant sequences create tension in themusculature inwardly from the electrodes and toward the center of themusculature. Significantly, the pulses of the sequences are spaced suchthat their continuous application maintains the tension created in atleast a large portion of the musculature by each preceding pulse of theresonant sequence.

In this manner, the musculature is uniformly developed, accounting forpatient and athlete balance concerns, and mitigating pain associatedwith sarcomere stretching, as well as dermal sting associated withexcessive current. The uniform development of the apparatus 10 isfacilitated by the ability of the resonant sequences to stimulate slowtwitch fibers in a fashion that preserves sarcomere bridges throughoutthe musculature. Because the preservation of the toggled bridgescorrelates closely to processes associated with a natural contraction, auser is spared pain associated with conventional stimulatorapplications. Furthermore, the preservation of tension within themusculature reduces the length and amplitude of applied pulses that mustbe applied to reconstruct a comparable contraction as compared todisjointed pulses of known techniques. As such, the absence of a single,large voltage pulse translates into less discomfort and greateraggregate muscle twitches for the user.

Furthermore, optimized frequencies of resonant sequences enable themusculature to distinctly register a succession of pulse characteristicswithin the span of a single contraction. More particularly, theapparatus 10 may vary the width, spacing, polarity, amplitude and/orshape of pulses comprising a sequence to combat accommodation andminimize discomfort. Such variation hinders the natural tendency of themusculature to adjust to and otherwise accommodate the signal,ultimately translating into deeper muscle penetration and decreaseddiscomfort.

Generally, FIG. 1 illustrates a user interface 11 coupled to astimulator 12 and an associated signal generator 14. A controller 16, orsuitable microprocessor, may receive input generated from the interface11. The stimulator 12 may use the input to configure resonant sequencesoperable to uniformly stimulate targeted muscle groups. To this end, thestimulator 12 may correlate the user input with signal profiles storedin a database 15 resident in a memory 18. As discussed below, eachprofile may embody signal characteristics optimized to uniformlystimulate muscle tissue with less pain and loss due to accommodation,from polarization and/or nutritional depletion.

As such, the controller 16 may process information extracted from thedatabase 15 for the purpose of sending a command to the signal generator14. In response to the command, the generator 14 may create a signalthat is conveyed to a user via at least two electrodes 20. Of note, atransmission medium suited to convey the signals may comprise multiplecables or circuits, depending on how many channels are conveyed by thegenerator to the electrodes 20. Furthermore, as discussed below, anembodiment may incorporate circuitry 13 adapted to manipulate thepolarity of the signal as discussed below in greater detail.

In response to a command from the stimulator 12 conveying theabove-specified parameters, the generator 14 and/or amplifier may createand transmit a signal to the user via the electrodes 20. Of note, theparameters of the generated signal will correspond to those indicated byuser input. As shown in FIG. 1 and discussed below in detail, thegenerator 14 preferably produces additional, complimentary signals forapplication to additional electrodes 20.

The electrodes 20 of FIG. 1 may contact the skin of a user proximate toa musculature to be exercised or treated. At least two electrodes may bepositioned near opposite ends of the musculature. As such, appliedsignals propagate inwardly from the ends of the musculature towards itscenter. Of note, the apparatus 10 also permits relatively distant musclegroups to be exercised as the generated signal propagates throughout thebody from the electrodes 20. Accordingly, the signal transmitted via theelectrodes penetrates and stimulates the various tissues of surroundingmuscles according to the generated signal. FIG. 2 illustrates anexemplary signal that may be generated within the environment of FIG. 1.

The signal may convey a series of resonant sequences as shown in FIG. 2.As discussed below in detail, suitable strings of sequences may bedistinct and/or mirror/complement each other as prescribed by a givenapplication. Furthermore, the number, width, amplitude, frequency andshape of each pulse of a resonant sequence, or of a resonant sequence,itself, may be selectively modified to achieve a desired effect. Eachsequence will preferably include at least three pulses. The frequency ofthe resonant sequences communicated via the electrode may rangegenerally from about 1 to about 4 kHz. Although the number of pulses maybe separately adjustable, such a configuration preferably allows forabout 1 to about 100 pulses per second. A single resonant sequence maylast for about 6-90 milliseconds. Of note, comparable, conventionalpulse frequencies and widths would quickly exhaust the nutrition andskew the electrical balance of a muscle, thus promoting accommodation.As such, the muscle would become unresponsive after only a few pulses,and the patient would likely experience a dermal stinging sensation.

The exemplary signal of FIG. 2 accounts for such conventional obstacles,in part, by interjecting downtime 25 on the order of about 5 to about500 milliseconds between resonant sequences 30, 32, 33, 35. Suchpreprogrammed periods 25 of rest enable muscle tissue to replenishenergy expended during the prior twitch or contractile advance. Asdiscussed below in detail, the stimulator 12 of FIG. 1 may vary thewidth, frequency, polarity and/or amplitude of each sequence 30, 32, 33,35 shown in FIG. 2 as needed to facilitate penetration. Further, theresonant sequences 30, 32, 33, 35 may be evenly or irregularly spacedfrom one another to combat accommodation and promote deepercontractions.

Individual pulses embedded within each resonant sequence 30, 32, 33, 35of FIG. 2 further contribute to the stimulation and recovery ofdifferent layers of musculature. Configurable characteristics of thepulses provide a mechanism for combating nerve boredom, and nutritionalstarvation as sources of accommodation while still achieving a thresholdpotential with less charge and associated pa over a larger number andspread of sarcomeres. As discussed above, threshold potential refers toa mum charge required to initiate a twitch, that is to say, a togglingof one or more bridges in the affected sarcomere leading up to acontractile reaction. Significantly, each pulse of a resonant sequencemay preserve and reinforce sarcomere bridges as the pulse propagatestowards the center of a musculature. Such preservation of tension cantranslate into more natural, deep and uniform contractions as explainedbelow.

FIGS. 11A-C illustrate an exemplary sequence of such a contraction thatis consistent with the principles of the present invention. That is, thesequence shows the propagation of resonant sequences traveling inwardlyfrom poles 180 of a muscle 182. For purposes of FIGS. 11A-C, theresonant sequences arrive from a stimulator 12 via electrodes 20positioned proximate the poles 180. As such, bridges in sarcomeres 184closest to the poles 180 of the muscle 182 flex, or toggle, in responseto a first pulse of a resonant sequence as illustrated in FIG. 11A.Thus, tension is initiated in extreme portions 186 of the muscle 182near the poles 180 as the pulse travels inwardly. Assuming that allpulses have the same rise time, that is to say, the same slewing rate,any pulse will start with the same reaction as shown in 11A and 12A. Thelonger it remains, the more of the cycle depicted in 12A-C is completeduntil it can respond no longer, untoggles and becomes unresponsive.

To further illustrate significant advantages realized by an embodimentof the invention, the resonant sequence-induced muscle contraction ofFIGS. 11A-C is concurrently contrasted against a reaction caused by asingle pulse that is long enough to affect a whole muscle ormusculature. As shown in FIG. 12A, the reaction initiated by the pulseis nearly identical to the muscle activity of FIG. 11A as theconventional pulse toggles sarcomeres 194 near the electrodes 202.However, superior contractile response and other advantages achieved bythe stimulator 92 of FIGS. 11A-C become more apparent as respectiveresonant sequences travel inwardly from the electrodes 20.

Lead pulses of resonant sequences of FIG. 11B propagate toward eachother from the electrodes 20. The sequences initiate toggling ofsarcomeres 184 resident in intermediate portions 188 of the muscle 182.Of note, electrical variation in the polarity of the arriving pulsesheighten the twitching reaction of the intermediate portions 188 ascompared to prior art applications, where accommodation may mitigatecontractile response as shown in FIG. 12B. Significantly, the arrival ofa second pulse of the resonant sequences of FIG. 11B at the poles 180has the affect of sustaining bridges initiated by the first pulse withinthe extreme portions 186.

That is, the second pulse may be spaced from the first by a distanceoptimized such that the second pulse reinforces and maintains togglingin the extreme portions 186 as the second pulse creates similar tensionin the intermediate portions 188. More particularly, the pulses may bespaced at around 3,500-7,000 microseconds. As it may take 10,000microseconds for sarcomere 184 bridges to toggle off, the prior arrivalof the second pulse preempts such bridge disconnection. Of note,variation in pulse characteristics discussed herein facilitate suchresponse by mitigating dampening affects associated with accommodation,as well as electrical and nutritional depletion.

In contrast to the sustained toggling of the extreme portions 186 asdiscussed above in the text accompanying FIG. 11B, comparable areas 186of the muscle 190 of FIG. 12B return to a relaxed position over the sameperiod. The prior art application of FIG. 12B may succeed in togglingintermediate portions 198 of the muscle 190, but such bridging isaccompanied by an absence of tension in the extreme areas 196. Thus, theinability of the conventional pulses to maintain toggling near theelectrodes 202 results in tension traveling arrhythmically across themuscle 190 of FIG. 12B, defeating a uniform contraction.

This critical distinction between the present embodiment and prior artapplications is further accentuated in FIG. 11C, where subsequent, thirdpulses of applied resonant sequences continue to sustain sarcomere 184bridges near the poles 180 as second pulses propagate to theintermediate portions. FIG. 11C shows such a scenario as both second andthird pulses maintain tension within their respective muscle portions188, 186. In this manner, tension is simultaneously maintainedthroughout the extreme and intermediate portions 186, 188 of the muscle182 as the first pulses continue to propagate towards the center 190 ofthe muscle 182. Sarcomeres of the center 190 bridge to facilitate auniform contraction across the entirety of the muscle 180. Of note, suchuniformity evades the prior art application of FIG. 12C in that only thecenter portion 200 of the muscle 190 toggles while the intermediate 198and extreme 196 portions relax.

In contrast, FIG. 11C shows the sarcomeres of the center portion 190creating strong bridges in response to the first pulses of the resonantsequences. Significantly, all portions 186, 188 and 190 of the muscle182, or musculature may be uniformly and simultaneously toggled. Thisfeature is enabled by the optimized spacing and pulse variation of theresonant sequences, which are configured to mitigate nutritional andelectrical exhaustion that frustrate prior art attempts to comparablecontractile reactions. Such uniform stimulation can translate into morenatural and deeper (resonant) contractions. Furthermore, the uniformityobviates much of the pain conventionally associated with sarcomerestretching. As discussed below in detail, variation of the pulsecharacteristics facilitates sustained sarcomere bridges enabling theuniformity shown in FIG. 11C by accounting for accommodation. Of note,additional pulses may be applied via the electrodes to further enhanceuniformity as the contractile reaction propagates inwardly throughoutthe muscle 182 or musculature.

As such, a user may select a number of pulses at block 11 of FIG. 1 thatwill comprise a resonant sequence. As shown in the exemplary userinterface 11 of FIG. 3, an operator may manipulate a dial 112 to specifyhow many pulses the generator 14 of FIG. 1 will include within anexemplary sequence having around a 7.6 millisecond span. Of note, apreferable setting for most healthy patients may comprise between fourand seven pulses. The stimulator 12 of FIG. 1 may set the voltage ofeach selected pulse to account for pulse number and duration.Alternatively, the user may manually adjust voltage using dial 114 ofthe interface 11 of FIG. 3 to a setting preferably ranging from about 1to about 150 volts. Of note, such range is merely exemplary and may beincreased substantially in special cases, such as with a denervatedpatient.

In this manner, the interface 11 allows a user to optimize the number ofpulses comprising a sequence such that sarcomere bridges of themusculature are maintained at the extremities of the musculature assubsequent pulses propagate toward its center. That is, while theresonant sequence is configured to induce only one, uniform contraction,the musculature may nonetheless register individual polarities and otherparameters of the pulses of the sequence. As such, the individualcharges of each pulse may evenly accumulate an aggregate charge acrossall tissues of the musculature. In this manner, the reinforced andevenly distributed bridges of the sarcomere provide a series of twitchessufficient to drive the contractile reaction. The absence of a largespiking voltages and muscle stretching associated with uneven musclecontraction achieves a more thorough contraction without the pain oftenassociated with such conventional pulse trains.

The user may further optimize the number of pulses selected at theinterface 11 of FIG. 3 to uniformly address different muscle types asthe signal propagates throughout the body of the user. For instance, aresonant sequence containing four to seven pulses may incorporate asufficient number of pulses to progressively stimulate the length of amusculature without overstimulating fast twitch tissue. As such, anoperator may accordingly adjust a dial 112 and corresponding number ofpulses in a sequence. Additionally, the pulses spacing between theselected number of pulses promotes a deep contraction in slow twitchtissues affected by the same signal. In this manner, the embodimentuniformly accommodates the different sensitivities of muscle groups.

Thus, a patient and/or technician may configure all of thepulse/sequence characteristics discussed herein via the exemplary userinterface 11 of FIGS. 1 and 3. For instance and as discussed below indetail, an operator may adjust another dial 117 to determine thefrequency of pulses associated with a signal. Most treatmentapplications preferably require anywhere from about 25 pulses per secondto about 70 pulses per second. Another dial 113 may proportionallycontrol the intensity or voltage associated with a signal relative to asecond, simultaneously and proximately applied signal. As also discussedbelow, an operator may adjust the polarity and rest periods in betweenresonant sequences via dials 116 and 15, respectively.

Features of the interface 11 configured to receive input may comprise aseries of dials as shown in FIG. 3. In the alternative, a combination ofswitches, keyboard, touch screen/pad, buttons, modem, microphone, or anyother known input mechanism may be employed. Alternatively or inaddition, a suitable user interface 11 may place little or no physicaldemands on a user. For instance, an exemplary interface 11 of FIG. 1 mayinclude voice recognition software, or incorporate handles or pedalsthat may be manipulated by merely bumping or squeezing.

For instance, exemplary handles 118 comprising the interface 11″ of FIG.4 may be manipulated by a user to control stimulator functions. As such,the user may grip orient, or contact the handles in such a manner as toaffect the voltage, frequency and rest periods associated with resonantsequences. For instance, a user may reverse the polarity of resonantsequences by tapping opposite ends 143 and 144 of the handles 146together. Such action may reduce stinging of the skin that may beassociated with applications of uniform polarity. Another embodiment mayinterpret the same action as a request from the user to incrementallyincrease voltage. Conversely, tapping opposite ends 145 and 147 maycause a decrease in voltage. Contacting all four ends 143, 144, 145, 147of the handles 146 may initiate a period of rest for the user,temporarily halting transmission of the stimulating signal. Otherparameters, such as package rate and channel balance may be accessibleto the user by contacting respective bottoms 144, 147 of the handles 146together. Such contact may alternatively or in addition, change a modeof the application, altering command/contact sequences of the handles146 to allow for the adjustment of additional parameters.

Another embodiment illustrated in FIG. 5, shows a battery operated userinterface 11″ configured to fit within a pocket or otherwise attach tothe clothing of a user. As with the larger, stationary embodiment shownin FIG. 3, the user interface 11″ of FIG. 5 incorporates multiple dials161-164 with which the wearer may adjust stimulator settings. Moreparticularly, dial 161 may communicate required voltage levels to thestimulator, preferably ranging from a fraction of 1 volt to about 150volts. Dial 162 may adjust, or balance, the relative voltage as appliedbetween respective channels leaving ports 165, 66 of the interface 11″.

In this manner, the interface 11″ facilitates stimulating differentmuscle groups according to tailored voltage levels. Dial 163 may controlthe frequency of pulses generated by the stimulator, and dial 164 mayinterject a proscribed ratio of rest periods between resonant sequences.Of note, dials 161-164 are merely exemplary and could each besubstituted or augmented with any number of functions controllingfeatures of a stimulating signal, to include phasic modulation and/orwaveform shapes. Also, the self-contained and portable nature of theuser interface 11″ enables a wearer to receive treatment whiletraveling, working or exercising.

A user interface of another embodiment may incorporate a hysteresis loopconfigured to monitor contractile, diagnostic or other patient/userreactions and automatically adjust signal generation, accordingly. Forinstance, the a sensor monitoring the heart rate of a patient may causethe stimulator 12 of FIG. 1 to step down voltage or interject a restperiod in response to detecting an elevated rate. Morever, a suitableuser interface may enable both the user and the operator to access theinterface. As such, the feature allows an athlete or patient to adjustsignal charge and other parameters of the stimulator signal per theirown tolerance levels and unique fitness goals.

Of note, the inclusion and optimization of pulses at the user interface11 of FIG. 1 further mitigates the effects of nutritional depletion andaccommodation. In addition to initiating and sustaining sarcomerebridges throughout the musculature, the optimized spacing between eachpulse further allows the musculature to perceive other characteristicsof each pulse. As discussed below in detail, an operator may access theinterface 11 to vary such pulse characteristics as polarity, amplitude,width and/or spacing as between pulses to realize additional benefits.For instance, such variation may limit the detrimental effects ofaccommodation on the sarcomere level. Ideally, the body will not havetime to adjust between different characteristics, and a deep level ofpenetration may be maintained. Rest periods in between pulses may allowthe musculature time to recalcify and replenish ATP, as well aselectrically reset.

Another benefit realized by the pulse configuration feature of theinterface 11 of FIG. 1 concerns patient discomfort. As discussed below,the variation of polarity as between respective pulses and sequences maybe made to equalize each other where desirable, decreasing theoccurrence of stinging surface sensation. Additionally, since the chargeof each pulse of a given resonant sequence is relatively low, theapplied signal does not subject the musculature to a single, largecharge pulse of a type conventionally associated with pain. In thismanner, the resonant sequence achieves a cumulative, high voltage chargewithout the detrimental side effects associated with a conventionalsingle pulse.

In response to the user selecting the number of pulses comprising aresonant sequence, the stimulator 12 of FIG. 1 may automaticallymanipulate the polarity of respective pulses within a resonant sequence.For instance, the controller 16 may retrieve from memory 18 a polarprofile, or template, that corresponds to the designated number ofpulses. As such, the polar profile associates a preprogrammed polaritywith each pulse of the resonant sequence. Within a given polar profile,a portion of the pulses may have a negative polarity, while theremainder exhibit positive characteristics.

The exemplary signal of FIG. 2 demonstrates such variation within eachresonant sequence. For instance, the polarity of first 22 and fourth 24pulses of a first resonant sequence are intermixed with pulses 26-28 ofopposing polarity. Variation in polarity serves to break upaccommodation in that change hinders the ability of the body to adjustto the pulses. Thus, the stimulator 12 of FIG. 1 adjusts polarity inresponse to input from the user interface 11 to enable greaterpenetration for subsequent pulses of a resonant sequence.

As shown in the interface 11 of FIG. 3, the user may further be promptedto alter the polarity of an entire resonant sequence. For instance, auser may turn a dial 116 on the interface 11 to select a number ofconsecutive resonant sequences to be generated before a sequence havingopposite polarity is presented. The exemplary signal of FIG. 2 has tworesonant sequences 30, 32 that are polar opposites of each other. Inthis manner, the settings of the interface 11 of FIG. 3 provide at leasttwo layers of phasic variation (at both the pulse and resonant frequencylevels) to promote deep muscle contraction and limit surface stinging.

The controller 16 of FIG. 1 additionally executes program code 17configured to manipulate the cumulative polarity of the resonantsequences of a signal. That is, a program 17 may mathematicallymanipulate the order and number of resonant sequences within a signal toachieve a desired balanced or net charge. For instance, the controller16 may repeat, insert and delete resonant sequences to ensure a desiredproportion of total signal charge is oriented at a specific polarity. Assuch, the controller may minimize surface charge and associated stingingby achieving a balanced charge.

Alternatively, the program 17 of FIG. 1 may configure resonant sequencesso as to induce a uniform flow of electrical charge. Such a net chargemay be appropriate where the operator wishes to open or constricttargeted blood vessels. Similarly, the program may employ a net chargeto squeeze or otherwise influence the function of lymph nodes or veins.As such, a suitable user interface 11 of FIG. 1 may include foursettings. One such setting of the interface 1 may include a firstcontrol for normal charge distribution. A second, exemplary setting maycorrespond to a moderately unbalanced, net charge. More extremeapplications, such as may be appropriate for some denervated patients,call for gross unbalancing, or even uniform polarity.

FIG. 6 shows an exemplary circuit suitable for implementing polarizingcircuitry 13 of FIG. 1 in such a manner as to prevent a pulse fromovershooting zero voltage upon its termination. An inability to regulatepolarity as such otherwise results in a net electrical imprecision. Asshown in FIG. 6, such polarity may be facilitated by polarizingcircuitry 13 comprising switching transistors 90, 92 and optical diodes102, 104 configured to regulate current flow in one direction.

More particularly, a signal transmitted from the generator 14 arrives atthe polarizing circuitry 13 via lines 87. As discussed below, the signalconveys its own series of resonant sequences tailored according to userinput. For efficiency and hardware consideration, the voltage associatedwith the signal remains relatively low when leaving the stimulator.Consequently, the voltage associated with the signal must be increasedprior to transcutaneous application at an electrode 20. To this end, thesignal passes through a switching transistor 90 to a transformer 94.

The transformer 94 steps up the voltage of the signal according to avoltage command transmitted from the generator 14 via line 96 andamplifier 98. The voltage command operates to apply voltage to thetransformer 94 and thus affect how much the voltage of the signal isstepped up. The voltage signal from the generator 14 may correlate touser input, for instance, dialed-in to the intensity setting 114 of FIG.3. This feature enables the magnitude of pulses to be varied accordingto therapeutic protocol and user tolerance. For instance, a user mayvaty voltage of a pulse between about 1 and about 150 volts.

The switching transistor 90 may continue to relay the signal to thetransformer 94 so long as voltage presented at its gate remains above athreshold voltage associated with the transistor 90. Should the voltagepresented by the signal at the gate fail to achieve the threshold level,then the transistor 90 will become unsaturated and the voltage signalwill drain to ground. Subsequently, no signal will be presented to thetransformer 94 for that period where voltage remains below the thresholdlevel. Of note, the threshold level and signal voltage may becoordinated such that signal will present a voltage at least equalingthe threshold level at a point of a resonant sequence corresponding to apulse. Thus, the binary nature of the switching transistor 90configuration may ensure that only voltage associated with pulses ispassed to an electrode 20.

In this manner, the transformer 94 steps up the voltage associated withthe pulse signal 87 prior to shaping it with an opto-isolator 100 andrectifying diodes 104. Absent such provision, transformer output wouldoscillate and swing above zero voltage at the terminal ends of eachpulse. Such imprecision could negatively affect aggregate charge relatedto a user via the electrode 20. Consequently, the opto-isolator 100receives the stepped up signal and acts as another layer of polarfiltration.

More particularly, an LED 103 of the opto-isolator 100 emits light inresponse to detecting current conveyed by the signal. A light sensingdevice 101 of the opto-isolator 100 detects the illumination and sends asignal to a rectifying diode 104, which further ensures the uniform andintended polarity of the signal. Thus, these components act in tandem toclip transformer output at the terminal end of a presented pulse. Whilethe inclusion of the opto-isolator 100 obviates a requirement for anelectrical connection and associated ground loops, it should beunderstood by one of ordinary skill that their functionality could bereplaced by switches and relays. Of note, the circuitry 13 of FIG. 6makes allowance for two different signals, transmitted over lines 87 and88. As such, the exemplary circuitry 13 provides a second opto-isolator105 configurable to communicate current and flow to a second rectifyingdiode 102 prior to transcutaneous application to the user via electrode20′.

Likewise, the apparatus 10 of FIG. 1 enables the simulator 12 tosimultaneously apply different resonant sequences to a muscle and/ormuscle group. For instance, the generator 14 may retransmit the originalsignal to a second electrode 20. As discussed above, the electrodespreferably apply their associated signals near respective ends of themusculature. Alternatively, the stimulator 12 may initiate thetransmission of some phasic variant of the original signal to the secondelectrode 20. The generator 14 may transmit the additional signals insuch a manner as to realize interactive or synergistic effects betweenthe signals discussed detail in below. As such, at least two signals maybe proximately applied and synchronized such that the combinedapplication emulates a single pulse having a width that exceeds theparameters of a conventional transformer.

This feature enables an operator to tailor pulse frequency towardsholistic muscle development. For instance, one embodiment of the presentinvention has particular application when attaching electrodes 20 ofFIG. 1 at extremities. The highest concentrations of fast twitch musclesare generally in the extremities to provide speed and fine control tothe hands and feet. As discussed above, fast twitch muscles reactquickly to individual pulses of a resonant sequence. The pulse spacingwithin a resonant sequence allows the fast twitch muscle to recover inbetween pulses in manner that avoids overstimulation and nutritionaldepletion. The optimized spacing of the pulses of an applied resonantsequence further enables the formation of sarcomere bridges within slowtwitch fibers of the muscle. Thus, charges of the individual pulsesaffect twitches uniformly throughout the musculature.

The sustained bridges of the sarcomere are accommodated by variation inpulse characteristics that register within the musculature. Moreparticularly, variation in pulse polarity, width, amplitude and spacingcan combat accommodation and enable greater penetration with lessdiscomfort. As such, a signal applied to the hand of a user may seemcomfortable to the fast twitch muscles of the carpal tunnel andforearms, while simultaneously stimulating the upper muscles of theupper arm and chest. Similar applications may be realized with therespective fast and slow twitch muscles of the feet and legs of a user.In this manner, the apparatus 10 capitalizes on the natural timing ofmuscle processes.

Of note, while the invention has and hereinafter will be described inthe context of a stimulator, controller, computer or other processor,those skilled in the art will appreciate that the various embodiments ofthe invention are capable of being distributed as a program product in avariety of forms, and that the invention applies equally regardless ofthe particular type of signal bearing medium used to actually carry outthe distribution. Examples of signal bearing media include but are notlimited to recordable type media such as volatile and non-volatilememory devices, floppy and other removable disks, hard disk drives,magnetic tape, optical disks (e.g., CD-ROM's, DVD's, etc.), amongothers, and transmission type media such as digital and analogcommunication links.

Morever, various programs described herein may be identified based uponthe application for which they are implemented in a specific embodimentof the invention. However, it should be appreciated that any particularprogram nomenclature that follows is used merely for convenience, andthus the invention should not be limited to use solely in any specificapplication identified and/or implied by such nomenclature.

The flowchart of FIG. 7 illustrates sequence steps suited for executionwithin the system hardware environment of FIG. 1. Namely, the exemplarysteps are suited to generate a resonant sequence in accordance with theprinciples of the present invention. As discussed above, each resonantsequence preferably contains at least three pulses. Regarding FIG. 3,the stimulator may select the number of pulses included within asequence at block 50 in response to user input.

As such, each resonant sequence will include periods of rest in betweenpulses. After each pulse of a resonant sequence, a musculature mayrequire a period of time to replenish some of the ionized calcium andATP's lost in reacting to the preceding pulse of the resonant sequence.This replenishment enhances the strength of the next twitch and breaksup accommodation in the sarcomere and fibril levels. The number ofpulses comprising a sequence can further be optimized to propagate acontractile reaction across a musculature while sustaining tensionthroughout. The number of pulses may additionally influence the extentto which the musculature is stimulated by the generated signal. Thisconsequence is a product of how different muscle groups react tostimuli.

For instance, a fast twitch muscle of a musculature may react to everypulse within a resonant sequence. As such, the number of pulses in asequence may be set at block 50 according to a number or frequency thatdoes not result in excessive downtime in between pulses. Such precautionhelps avoid painful jerking reactions and under stimulation in fasttwitch muscles. Because a slow twitch muscle can not respond as quicklyto the potentials of high frequency pulses, care is taken to configurepulses so as to compliment the natural, harmonic frequency of the slowtwitch muscle.

For instance, while a resonant sequence containing over eight pulses maybe too fast to register with the slow muscle, a smaller, optimizednumber of pulses within a sequence may achieve a resonant affect. Thatis, the charge of the pulses initiates and sustains bridging ofsarcomeres throughout the musculature leading to a single, synergisticpulse. Of note, care is taken not to overload the fast twitch muscles.As such, the fast twitch muscles have time to recover in between pulses,translating into decreased tension and pain. As with many of thesettings addressed herein, the number of pulses in a resonant sequencerequired to achieve a maximum harmonic affect may vary according to thecondition and tolerance of the user. For instance, a patient with severemuscle denervation may tolerate over seven pulses within a resonantsequence. In many cases, however, the four to seven pulses per burstdemonstrates optimum results.

Having used the interface to specify the number of pulses at block 50,program code executed by the controller may assign a polar profile tothe resonant sequence at block 52. Namely, the controller may associatethe requested number of pulses with a polar profile or templatemaintained within the database. As such, the polar profile associatesthe requested number of pulses with predetermined polarities. Thedatabase may store multiple combinations of such polar profiles for eachpulse count. As discussed above, polarity may vary to combataccommodation, as well as to adjust net charge. Alternating polarity canfacilitate maintaining tension across the musculature, as the featurecan mitigate the affects of accommodation that could break sarcomerebridges or necessitate more voltage.

Having varied the polar sequences of pulses within a single resonantsequence at block 52, the stimulator may alter the polarity of eachresonant sequence at block 54. More particularly, an operator mayspecify the number of resonant sequences generated before the polarityof a resonant sequence or group of resonant sequences is inverted. Forinstance, a user interface may prompt an operator to specify that thepolarity of resonant sequences should be reversed after every threesequences. As above, changes in polarity can mitigate the effects ofaccommodation. Absent such variation, a musculature may begin to adaptto a repeated pulse pattern after a few cycles, compromisingpenetration. By reversing the polarity of the resonant sequence, amusculature may perceive the inverted resonant sequence as being anentirely distinct resonant sequence. As such, a musculature that hasadjusted itself to accommodate a given resonant sequence may nonethelessreact to the same sequence with reverse phasing. In this manner, thestimulator provides layers of phasic variance at both the pulse andresonant sequence levels.

At block 56 of FIG. 7, the stimulator may vary the order of invertedresonant sequences to obtain mathematical consistency with regard tophasing and pulse length. The goal of the manipulation may includerealizing a balanced or desired net charge. For instance, the controllermay mathematically manipulate resonant sequences to ensure a desiredproportion of signal charge is oriented at a specific polarity. In mostcases, the controller will repeat, insert and delete resonant sequencesto realize a balanced charge, minimizing surface charge and associatedstinging.

In another application at block 56, an operator may desire to induce auniform flow of electrical charge. Such a net charge may be appropriatewhere the operator wishes to open or constrict targeted blood vessels.Similarly, the stimulator may employ a net charge to manipulate thefunction of lymph nodes and the contractions of localized cells. Assuch, an exemplary user interface may include four settings. Forinstance, suitable settings of an interface may include one for normaldistribution and a second setting configured to promote minor unbalance.More extreme applications may call for a grossly unbalanced charge, oreven uniform polarity.

The stimulator may then generate a first signal at block 58 inaccordance with the specified resonant sequence parameters. As such, thesignal may be transmitted via the electrode to the musculature.Preferred applications may call for the generation of additional signalsat block 58. The stimulator may employ the additional signals in such amanner that a synergistic or compound effect is realized. For instance,the coordinated charge of two proximately applied signals can emulate asingle, longer pulse. Of note, the pulse width and voltage realized bysuch a configuration may exceed that available via a single generatingtransformer. As such, the dual signal feature can overcome equipmentlimitations to achieve greater muscle penetration. As discussed below,additional compounding and harmonic effects may be achieved bysimultaneously applying multiple signals.

To this end, the controller may reuse the profile used to recreate theoriginal signal at block 58. As such, the generator may transmit theoriginal signal to a second electrode at block 58. Alternatively, thegenerator may initiate the transmission of some phasic variant of theoriginal signal to the second electrode. An exemplary user interfaceconfigured to account for such phasic variation may include a dial,touch pad or other mechanism configured to select from among differentsignal generation schemes.

FIG. 8 illustrates three exemplary signals that may be applied to theuser in conjunction with an original signal 80. More particularly, theexemplary in-phase application 82 of FIG. 8 may be applied to a user viaa second electrode placed proximate to the first, which conveys theoriginal signal 80. As such, the in-phase signal 82 mirrors the resonantsequences of the original channel 80. In this manner, signal strength isreinforced as both channels propagate throughout the user. A thirdchannel 84 may duplicate the original signal 80 beginning at the end ofthe first pulse 85 of the original 80. Still a fourth application maycause each pulse of the resultant signal 86 to initiate at the end ofeach pulse of the original signal 80. A musculature may perceive such anapplication as having seamless pulses of twice the width of the originalpulse 80. Such a design can have particular application where denervatedpatients require pulses of greater width than are available viaconventional transformers.

All three signals illustrated in FIG. 8 are appropriate for therapeuticapplication, two signals 84, 86 further facilitate muscle growth. Ofnote, the order in the which the channels are transmitted may varyrelative to one another. For instance, one application may call for anoriginal signal 80 transmitted via a first electrode to be followed bythe out-of-phase signal 84 emanating from a second electrode. To achievegreater muscle penetration, the controller may reverse the relativeorder of the signals such that the original signal 80 executes insuccession to the other 84. This feature represents yet another layer ofvariation available to overcome accommodation.

In this manner, the changing phasic relationship of two signals maycombine to generate deeper muscle contractions with less associatediscomfort. That is, the body will not have time to adjust to or bracefor changes in the signal sequence. Consequently, applied charges neednot be increased to maintain constant levels of stimulation. Becauseapplied charge can be proportional to patient discomfort, the stimulatorenables more contractile reaction with less pain. As discussed above.The exemplary user interface 11 of FIG. 3 may further allow a user toadjust the relative strength of two signals in proportion to each other.

As may be appreciated, the inclusion of additional signals can realizestill further penetration and additional sub-harmonics. For instance,the stimulator may simultaneously employ the signals to differentelectrodes. The controller may further redirect respective signals todifferent electrodes and corresponding muscle groups. Such anapplication may promote balanced muscle development while breaking upaccommodation.

Also of note, the flexible interface and electrode configuration of theabove described embodiment may enable an athlete or patient to performathletic or therapeutic motions while the stimulator concurrentlyexercises the musculature. As such, an operator may limit appliedelectrodes to a number sufficient to avoid encumbering the athlete fromaccomplishing a desired range of motion. For instance, a user maysimulate an arm swing appropriate for a tennis racquet, baseball bat orgolf club while electrodes on the swinging arm communicate musclebuilding signals. This feature enables a musculature of the athlete tobe stimulated at different stages of contraction, translating into morebalanced muscle development and training.

Returning to FIG. 6, the stimulator may manipulate the shape of eachpulse at block 60 to capitalize on the manner in which nerves of thebody react to stimuli. For instance, FIG. 9 shows a conventional squarepulse 70 that the may be generated in accordance with the principles ofthe invention. Such a square pulse 70 may have particular applicationwhere a user requires relatively more rest in between pulses toreplenish lost resources. FIG. 9 additionally illustrates another pulseformation 72 available for generation within the confines of the presentembodiment. As shown in the figure, the trailing edge of the pulse 72exemplifies faradic characteristics. That is, the trailing edge of thepulse lingers and trails off.

This trailing, or faradic feature shown in FIG. 9 causes the pulse 72 tomore gradually discharge throughout the musculature in a manneranalogous to that of a capacitor in a circuit. In fact, one embodimentmay cause a transistor to discharge an actual capacitor into the skin ofthe user in response an absence of current in order to form the pulse72. A resistance circuit may further contribute to the naturalresistance of the skin to facilitate voltage bleed off. Alternatively, agenerator or transistor may be tasked to form a faradic wave at lowvoltage. Such a waveform may be amplified at output.

A sensory nerve processing a pulse 72 of FIG. 9 produced in such amanner may perceive the immediate portion of the trailing edge asconstituting the end of the signal. This feature may serve to relax andcalm the sensory nerve, diminishing the occurrence of muscle tightening.Significantly, a motor nerve reacting to the same pulse 72 may continueto react to the trailing portion of the pulse 72. In is manner, theembodiment extends the period of work affecting the musculature withoutunduly taxing sensory nerves.

Significantly, the decaying pulse 72 of FIG. 5 is more like what thebody naturally produces than the conventional square pulse 70. Suchcharacteristics are desirable because nerve fibers make for relativelypoor conductors absent the natural, active processes of the muscle.Consequently, emulation of natural impulses realized by the pulsesculpting feature of block 60 of FIG. 7 invokes natural processes andpromotes current flow at lower voltages. As such, applied charges mayalternatively be increased to achieve deeper contractions. Of note, bothtypes of pulses shown in FIG. 9 can be used in tandem to vary stimuliand overcome accommodation.

In nature, signals from the brain taper to allow replenishment andenhance the strength of a next occurring twitch. Acknowledging thisphenomenon, the stimulator at block 62 of FIG. 7 may shorten the widthof successive pulses of a resonant sequence as a muscle tires. Forinstance, the duration of pulses included in resonant sequences 81, 83,85 of FIG. 10 gradually taper on the order of ten to twenty percent. Thewidth of successive pulses of resonant sequence 30 of FIG. 2 similarlywane. In this manner, a musculature perceives the decaying signal asbeing more like those naturally produced by the body.

The shortened pulse width will also decrease pain at the fascicle tissuelevel. Of note, this feature enables contractile responses at lowercharge levels. Consequently, the stimulator may operate at charge levelsthat induce less pain in a user. As such, the feature allows a user tocomfortably increase charge to allow greater penetration and overcomeaccommodation. Similarly, width may vary as between consecutive resonantsequences to achieve other comfort and therapeutic benefits.Furthermore, one skilled in the art should recognize that the order ofpulses of varying width, shape or magnitude need not require one pulesto immediately follow another, any sequence of like and dissimilarpulses may be generated in accordance with the principles of the presentinvention.

Despite the rest periods and other provisions built-in to the generatedsignal, certain users may require additional rest to more thoroughlyreplenish lost ATP and ionized calcium. Consequently, one embodiment mayinclude a rest-on-demand function. As such, a user may manipulate theinterface 11 of FIG. 1 to pause the transmission of signals to theelectrode(s). For example and as discussed above in the textaccompanying FIGS. 35, a user may bump a handle 118 or petal configuredto temporarily cease transmission in response to contact.

Of note, because generated signals of the embodiment balance electricalpolarities and replenish lost resources continuously, the musculaturemay require only a few seconds of rest to completely recover.Furthermore, such short rest periods may be preprogrammed into atreatment or training protocol. Of note, one embodiment slowly ramps upthe voltage following a such downtime to facilitate a gradual,relatively painless transition.

It will be appreciated that the generation of the various resonantsequence profiles and associated pulse shapes discussed herein may beimplemented using hardware and/or software to store and/or generate theappropriate profiles and shapes, and that such implementations would bewithin the abilities of one of ordinary skill in the art having thebenefit of this disclosure.

While the present invention has been illustrated by a description ofvarious embodiments and while these embodiments have been described inconsiderable detail, it is not the intention of the applicants torestrict or in any way limit the scope of the appended claims to suchdetail. For instance, one embodiment that is consistent with theinvention may include a therapeutic or developmental instrument thatincludes hardware and/or software for stimulating a muscle. Such aninstrument may comprise, for instance, a golf club, a baseball bat, alacrosse stick, a tennis racquet or a hockey stick, among othersports-related instruments. Still other suitable instruments may includea writing instrument, such as a pen. In the case of a golf club, amuscle of a user may be stimulated by the instrument as the golferpractices her swing. Combining such muscle stimulation with the act ofpracticing the movement of the swing has a synergistic effect of‘training’ the muscle as it builds strength. Similarly, a partialparalytic may regain strength in their hand by holding and writing witha pen configured to transcutaneously deliver a stimulating signal.

Where desired, the instrument may include at least one electrodeconfigured to deliver a stimulating signal to the holder of theinstrument. For instance, two electrodes may be included within the gripof the club or racquet. That is, electrodes may be positioned on theoutside of the instrument so as to contact the hands of the user. Assuch, different parts of a hand and/or different hands will contactelectrodes configured to deliver the signal. In another or the sameembodiment, wired electrodes may extend from the instrument or anadjacent signal generator to the holder of the instrument. Thisconfiguration may allow other, targeted muscles to be concurrentlystimulated while the user manipulates the instrument. The generator ofanother embodiment is contained within or is otherwise attached to theinstrument. As such, the instrument may include batteries and/or a portfor receiving electrical power.

In any case, the instrument may include a user interface, such asbuttons, dials and/or switches as described herein to manipulate thesignal. Other user input devices may include a microphone for use inrecognizing voice commands, as well as a motion sensor. A motion sensor,may, for instance, activate a signal generation and delivery sequenceaccording to the sensed motion of the instrument.

Additional advantages and modifications will readily appear to thoseskilled in the art. The invention in its broader aspects is thereforenot limited to the specific details, representative apparatus andmethod, and illustrative example shown and described. For instance,features of the present invention may have particular application intreating arthritis and diabetes, in addition or in the alternative tostimulating a muscle. Other embodiments may use signals to treatvascular disease, carpal tunnel syndrome, hair loss, paralysis, erectiledysfunction, pain, vocal therapy, cancer, diseases affecting the nervoussystem and internal organs, skin disease and virtually any malady whereincreased blood flow facilitated by embodiments of the invention may beappropriate. Success in these areas may be attributable, in part, to themanipulation of blood flow enabled by embodiments of the invention. Forinstance, an apparatus consistent with the invention may increase bloodflow according to the signal's travel through a musculature. Other usesof the present invention may extend to the field of chiropracty. Amethod consistent with the invention may provide particular benefits ifused to stimulate a musculature within a relatively short period of timefollowing an injury. Accordingly, departures may be made from suchdetails described herein without departing from the spirit or scope ofapplicant's general inventive concept.

1. A method of treating diabetes, comprising applying a stimulatingsignal to a user, wherein the stimulating signal is configured tomanipulate blood flow.
 2. The method of claim 1, wherein applying thestimulating signal further includes applying a stimulating signalcomprising a resonant sequence that includes at least three pulses, andwherein the pulses of the resonant sequence are spaced relative to oneanother such that each pulse subsequent to a first pulse in the sequenceis effective to progressively stimulate and create tension in amusculature that includes the muscle inwardly from the electrodes andtowards the center of the musculature while maintaining the tensioncreated in at least a portion of the musculature by each preceding pulsein the resonant sequence.
 3. A method of stimulating a muscle comprisingapplying a stimulating signal to a user using a pair of handlescomprising electrodes configured to apply the stimulating signal to theuser.